Andersen Mikkel Ø, Carreon Leah Y, Hummel Stefan, Smith Elisabeth C, Andresen Andreas K
Center for Spine Surgery and Research, Lillebaelt Hospital, Kolding, Denmark.
Institute of Regional Health Research, University of Southern Denmark, Campusvej 55, DK-5230, Odense M, Denmark.
Brain Spine. 2025 Apr 28;5:104268. doi: 10.1016/j.bas.2025.104268. eCollection 2025.
Lumbar spinal stenosis (LSS) is a degenerative condition causing back and leg pain, limiting walking due to neurogenic claudication. It affects 9-11 % of the population, rising to 47 % in those over 60, with cases expected to increase as the population ages. Non-surgical treatments are considered first-line options, although their effectiveness remains uncertain. Decompression surgery is still commonly performed for severe cases, even though a review comparing conservative treatments with surgical procedures, including spinal decompression, found no clear superiority of surgery. In Denmark, LSS accounts for 35 % of spinal surgeries in adults.
Does spinal decompression improve walking distance and gait speed in patients suffering from LSS?
Consecutive patients scheduled for decompression due to spinal stenosis enrolled at a regional spine centre. Timed walking distance (maximum of 1000m) was performed at baseline and at 3-, and 12 months post-op.
One hundred and one patients were included in the study, mean age was 70.7 years, 77 % were female, with 90 % having had symptoms for more than 6 months prior to surgery.Walking distance (123.9m-791.1m, p < .001) and speed (0.91 m/s to 1.17 m/s, p < .001) improved at one year after surgery.
Patients with severe walking impairment caused by spinal stenosis experienced substantial improvement of both walking speed and walking distance at all follow-up time points after undergoing spinal decompression.
腰椎管狭窄症(LSS)是一种退行性疾病,可导致腰腿痛,因神经源性间歇性跛行而限制行走。它影响9%至11%的人群,在60岁以上人群中这一比例升至47%,预计随着人口老龄化,病例数还会增加。非手术治疗被视为一线选择,但其有效性仍不确定。尽管一项比较保守治疗与手术治疗(包括脊柱减压)的综述发现手术并无明显优势,但减压手术仍常用于严重病例。在丹麦,LSS占成人脊柱手术的35%。
脊柱减压能否改善腰椎管狭窄症患者的行走距离和步态速度?
在一个地区脊柱中心招募因椎管狭窄计划进行减压的连续患者。在基线、术后3个月和12个月时进行定时行走距离(最长1000米)测试。
101名患者纳入研究,平均年龄70.7岁,77%为女性,90%在手术前有症状超过6个月。术后一年,行走距离(123.9米至791.1米,p<0.001)和速度(0.91米/秒至1.17米/秒,p<0.001)均有所改善。
因椎管狭窄导致严重行走障碍的患者在接受脊柱减压后,在所有随访时间点的行走速度和行走距离均有显著改善。